The Medical Case Manager provides in-person and telephonic case management to injured workers, collaborating with patients, providers, and employers to facilitate recovery. Responsibilities include assessing, planning, implementing, and evaluating patient progress while ensuring treatment plans are appropriate, medically necessary, and cost-effective.
Remote Full Time Jobs in United States (116,977)
Remote in = United States
Job type = Full Time
The specialist manages lower-level, non-complex workers’ compensation claims within delegated authority, ensuring the best possible outcome under senior supervision. Key duties include receiving claims, confirming coverage, determining validity, establishing reserves, authorizing payments, and communicating claim status to relevant parties.
Auto and General Liability Claims Specialist
CorVel Corporation
·
Full Time
·
12 Weeks Ago
CorVel Corporation
The specialist will manage low to mid-level complex auto and general liability claims, including bodily injury and property damage, while confirming policy coverage and establishing reserves. Responsibilities also include communicating claim status to all relevant parties and adhering to client and carrier guidelines.
Auto and General Liability Claims Specialist
CorVel Corporation
·
Full Time
·
12 Weeks Ago
CorVel Corporation
The specialist will manage low to mid-level complex auto and general liability claims, including bodily injury and property damage, focusing on achieving optimal outcomes. Essential functions include receiving claims, confirming coverage, investigating, establishing reserves, authorizing payments, and communicating claim status to all relevant parties.
Customer Service Representative I - Workers' Compensation Call Center
CorVel Corporation
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Full Time
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12 Weeks Ago
CorVel Corporation
The Customer Service Representative manages inbound and outbound calls for the Workers’ Compensation department, providing service to claimants and internal teams. Responsibilities include reviewing claim history, clarifying details with adjusters, resolving inquiries, and accurately documenting all interactions.
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The Medical Case Manager provides in-person and telephonic case management to injured workers, involving various stakeholders like physicians and employers, utilizing nursing knowledge to discuss and evaluate treatment plans for appropriateness and cost-effectiveness. Responsibilities also include attending provider visits, facility discharge planning, conducting home evaluations, and negotiating care implementation such as durable medical equipment.
The Medical Case Manager provides in-person and telephonic case management to injured workers, collaborating with patients, providers, and employers to facilitate recovery. Responsibilities include utilizing nursing knowledge to discuss and evaluate treatment plans for appropriateness, medical necessity, and cost-effectiveness, often requiring significant local travel.
The Account Manager is responsible for executive-level customer interaction, acting as a client extension to understand and communicate expectations, and increasing market share by delivering service that meets or exceeds customer goals. Key duties include managing accounts with significant revenue thresholds, conducting client stewardship, handling collections, and driving revenue growth with existing accounts.
The Medical Case Manager provides in-person and telephonic case management to injured workers, involving various stakeholders to facilitate recovery. Responsibilities include assessing, planning, implementing, and evaluating patient progress while discussing and evaluating treatment plans for appropriateness and cost-effectiveness.
The Billing Specialist is responsible for completing invoicing processes for all Ancillary Healthcare services, which involves administrative review of vendor and provider bills to determine appointment types. This role also generates vendor payments and customer invoices while maintaining a high focus on accuracy and urgency to meet service level expectations.
The supervisor is responsible for overseeing the daily operations of the claims staff, ensuring adherence to quality, productivity, and customer service standards while supporting departmental goals. This role involves assisting management with staffing functions and providing technical guidance on complex claims, investigation, and litigation issues.
The Team Lead manages and directs the daily activities of the support team, including scheduling standups, managing calendars, approving PTO, and ensuring adequate queue coverage. This role involves developing annual goals, conducting quarterly coaching sessions, and communicating team progress to Support Management.
The Account Manager serves as an executive-level customer contact, responsible for understanding expectations, communicating them to field offices, and increasing market share through excellent service and introducing additional services. Key duties include providing consultative services, managing revenue growth for accounts over $1M each, handling collections, and conducting regular client stewardship meetings.
The HRIS Manager will serve as the functional and strategic lead for Human Resources Information Systems, overseeing system operations, reporting, and data quality while leading and mentoring a small HRIS team. This role involves acting as the primary contact for external UKG resources and leading HRIS-related projects from requirements through implementation.
The Claims Specialist manages lower-level, non-complex workers’ compensation claims within delegated authority to achieve the best possible outcome under direct supervision. Responsibilities include receiving claims, confirming coverage, determining validity, establishing reserves, authorizing payments, and communicating claim status to relevant parties.
The Medical Case Manager provides in-person and telephonic case management to injured workers, involving various stakeholders like physicians and employers, utilizing nursing knowledge to discuss and evaluate treatment plans for appropriateness and cost-effectiveness. Responsibilities also include attending provider visits, discharge planning conferences, conducting home visits, and negotiating the delivery of necessary medical equipment and services.
This role involves managing the Professional Services Department, including assigning implementation work orders, overseeing staff performance, reviewing work, and providing guidance to implementation consultants. The Associate Director will also be responsible for developing training materials, resolving client issues, and ensuring overall client satisfaction.
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The Technical Sales Manager will act as a trusted technical advisor, matching customer needs with existing products or recommending alternatives to drive growth and success. Key duties involve leading foundry testing, supporting customer audits, participating in specification negotiations, and representing the company at industry events.
The Medical Case Manager provides in-person and telephonic case management to injured workers, collaborating with patients, providers, and employers to facilitate recovery. Responsibilities include assessing, planning, implementing, and evaluating patient progress while ensuring treatment plans are appropriate, medically necessary, and cost-effective.
The Senior Claims Specialist manages complex Workers' Compensation claims by confirming coverage, determining compensability through investigation, and establishing reserves. This role involves developing action plans with case managers, coordinating return-to-work efforts, managing subrogation and litigation, and ensuring adherence to client and carrier guidelines.
The Claims Specialist manages lower-level, non-complex workers’ compensation claims within delegated authority to achieve the best possible outcome, operating under the direct supervision of a senior claims professional. Essential functions include receiving claims, confirming coverage, determining validity, establishing reserves, authorizing payments, and communicating claim status to relevant parties.
The Business Analyst translates workflow processes into clear business requirements and acts as a liaison between stakeholders and development teams to drive automation, quality control, and application enhancements. Key duties involve collaborating on product projects, analyzing data for insights, participating in quality assurance, and developing comprehensive documentation and training materials.
WordPress Support Specialist (Contractor)
Mannix Marketing
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Full Time
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12 Weeks Ago
Mannix Marketing
The specialist will resolve incoming support tickets via Zendesk, handling tasks like content updates, plugin issues, and broken layouts across custom-coded WordPress client sites. Responsibilities also include performing edits on custom PHP/theme sites and managing/troubleshooting hosting issues like cPanel and DNS records.
The WC Claims Specialist manages lower-level, non-complex workers’ compensation claims within delegated authority, confirming coverage, determining compensability, establishing reserves, and authorizing payments. This role involves communicating claim status with customers, claimants, and clients while adhering to guidelines and assisting with more complex claims as needed.
The Telephonic Case Manager coordinates resources and develops cost-effective, personalized care plans for ill or injured individuals, aiming to support quality treatment and timely return to work. This involves assessing treatment plan appropriateness, communicating with physicians, and explaining conditions and plans to patients, families, and adjusters.
Bilingual Telephonic Case Manager I
CorVel Corporation
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Full Time
·
12 Weeks Ago
CorVel Corporation
The Bilingual Telephonic Case Manager coordinates resources and develops cost-effective, personalized care plans for ill or injured individuals, aiming to support quality treatment and timely return to work. This involves assessing treatment plan appropriateness, communicating with physicians, and explaining medical conditions to various stakeholders.
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The Field Data Specialist is responsible for gathering, organizing, packaging, and presenting operational data, translating numerical information into a consumable format for various stakeholders. This includes entering data from source documents into the computer system, ensuring data quality, and managing the data request intake queue.
Bilingual Advanced Practiced Provider - San Luis, AZ
Monogram Health
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Full Time
·
12 Weeks Ago
Monogram Health
The Advanced Practitioner will deliver personalized, compassionate medical care primarily to patients with CKD and/or ESRD/ESKD through comprehensive annual wellness exams conducted both in-home and virtually. Responsibilities also include coordinating care with other providers, maintaining accurate patient records, and implementing evidence-based treatment plans to reduce hospitalizations and maximize patient quality of life.
Bilingual Customer Service Representative I (English & Spanish)
CorVel Corporation
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Full Time
·
12 Weeks Ago
CorVel Corporation
The representative addresses client and/or provider inquiries through various communication channels like email, fax, and phone, ensuring compliance with contractual and state guidelines. Essential functions include answering calls/emails, reviewing provider history in specific systems, consulting supervisors, contacting providers, and maintaining necessary reports.
The WC Claims Specialist manages lower-level, non-complex workers’ compensation claims within delegated authority, aiming for the best possible outcome under senior supervision. Essential functions include receiving claims, confirming coverage, determining compensability, establishing reserves, authorizing payments, and communicating claim status to relevant parties.
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